Organization Active NPI

Cleburne Digestive Health PLLC

  • Gastroenterology Physician
  • Cleburne, TX
National Provider Identifier
1447405535
Registry record updated Nov 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CLEBURNE DIGESTIVE HEALTH PLLC
Practice address
1701 Walter Holiday Dr Ste 200
Cleburne, TX 76033-1189
Phone
(817) 760-0234
Fax
(817) 641-3355
NPI assigned
Nov 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yevgeniy OstrinskyNPI 1790998771
Title
President
Phone
(817) 760-0938

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1701 Walter Holiday Dr Ste 200
Cleburne, TX 76033-1189

Mailing address

1701 Walter Holiday Dr Ste 200
Cleburne, TX 76033-1189
Phone (817) 760-0234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090720000251 TX Part B Supplier - Clinic/Group Practice 5092867291 Receives reassigned benefits from 1 practitioner
Practice locations: Cleburne, TX

National Provider Directory

National Provider Directory

Locations

1701 Walter Holliday Dr
Ste 200
Cleburne, TX 76033
Phone (817) 205-3075

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHAHAA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542412800000",
    "number": "1447405535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WALTER HOLIDAY DR STE 200",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760331189",
            "telephone_number": "817-760-0234",
            "fax_number": "817-641-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 WALTER HOLIDAY DR STE 200",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760331189",
            "telephone_number": "817-760-0234",
            "fax_number": "817-641-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEBURNE DIGESTIVE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2018-11-17",
        "status": "A",
        "authorized_official_last_name": "OSTRINSKY",
        "authorized_official_first_name": "YEVGENIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-760-0938"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.